Impact of Prenatal SSRI Exposure on Preterm Birth and Other Neonatal Complications

Although preterm birth is the largest single cause of neonatal and infant death and fosters neurological disabilities, how prenatally administered selective serotonin reuptake inhibitors (SSRIs) affect these conditions is still incompletely understood. Using national Finnish registry data on live births in 1996 through 2010, researchers compared all women with SSRI-exposed pregnancies (N=15,729; of 4811 with available diagnoses, 98.0% had affective disorders), those with psychiatric diagnoses unexposed to SSRIs (N=9652, 97.5% with affective disorders), and control mothers with neither SSRI exposure nor psychiatric histories (N=31,394).

Analyses adjusted for maternal demographics, parity, smoking, and social and medical characteristics. Compared with nonexposed, psychiatrically diagnosed women, SSRI-exposed women had 16% lower risk for late preterm birth, 48% lower risk for very preterm birth, and 30% lower risk for cesarean section. While not associated with higher rates of congenital abnormalities, SSRI use was associated with 32% higher risk for 5-minute Apgar score <7 and 24% higher risk for monitoring in neonatal care units (NICUs); risk for hypertension of pregnancy was marginally increased. SSRI exposure in second and third trimesters was associated with higher rates of neonatal problems. Compared with control mothers, SSRI-exposed mothers had higher risks for all neonatal problems.